两种非球面衍射型多焦点人工晶状体植入术后的短期视觉质量比较

Comparison of visual qualities after the implantation of two different aspherical multifocal intraocular lens

目的比较Tecnis ZM A00和Re STOR+3.0D两种多焦点衍射型人工晶状体(IOL)植入后的视觉功能。设计回顾性比较性病例系列。研究对象老年性白内障行超声乳化白内障吸除联合IOL植入术患者78例(113眼)。其中Tecnis ZM A00组41例(60眼),Re STOR+3.0D组37例(53眼)。方法比较两组患者术后1、3个月明暗环境下的最佳近距离矫正视力(BCNVA)、最佳中距离矫正视力(BCMVA,60 cm)和最佳远距离矫正视力(BCDVA),离焦曲线和伪调节力。并采用问卷调查的方式了解两组患者术后视觉效果。主要指标明暗环境下的BCNVA、BCMVA和BCDVA,离焦曲线,伪调节力,问卷调查。结果术后3个月,Tecnis ZM A00和Re STOR+3.0D组在正常光线下的BCDVA、BCNVA、BCMVA分别为0.975±0.182和0.953±0.133,0.713±0.234和0.621±0.299,0.262±0.110和0.309±0.090(P均>0.05);两组在暗环境下BCNVA分别为0.283±0.103和0.201±0.082(P<0.05),BCMVA分别为0.339±0.097和0.367±0.101(P>0.05);离焦曲线显示,两组分别在-0.25 D、-0.25 D及-2.75 D、-2.25 D处形成远近两个峰值焦点;两组IOL的伪调节力分别为1.323±1.033和1.301±1.127(P>0.05);两组患者脱镜率、产生眩光光晕等不良视觉质量差异无统计学意义。结论 Tecnis ZMA00和Re STOR+3.0D衍射多焦点IOL均能提供较好的远、中距离视力及一定范围的近视力,改善患者的视觉质量。Tecnis ZM A00能提供更好的暗环境下的近视力及中距离视力。

Objective To compare the visual quality after the implantation of the two kinds of aspheric diffractive multifocal in- traocular lens （Tecnis ZM A00 and ReSTOR ＋3.0D）. Design Retrospective comparative case series. Participants 78 patients （113 eyes） with senile cataract that underwent phacoemulsification and aspheric diffractive multifocal intraoeular lenses implantation in Beijing Tongren Hospital were included. 78 patients （113 eyes） were divided into two groups, Tecnis ZM A00 group （41 patients, 60 eyes） and ReSTOR ＋3.0D group（37 patients, 53 eyes）. Methods The difference of best corrected distance visual acuity （BCDVA）, best corrected near visual acuity （BCNVA）, best corrected mid-distance visual acuity （BCMVA, 60cm） under light and shade circumstance, defocus testing and pseudo accommodation were compared at 1 and 3 months after the operation. The questionnaire of visual quality was used to observe the patents＇ visual condition at 3 months after the operation. Main Outcome Measures BCDVA, BCNVA, BCMVA （60em） un- der light and shade circumstance; defocus testing; questionnaire scores. Results Under light circumstance, BCDVA, BCNVA, BCMVA （60 cm） in the Tecnis ZM A00 and ReSTOR ＋3.0D group was 0.975±0.182 and 0.953±0.133, 0.713±0.234 and 0.621±0.299, 0.262± 0.1 10 and 0.309±0.090 respectively at 3 months after the operation （all P〉0.05）. Under shade circumstance, BCNVA was 0.283±0.103 and 0.201±0.082 （P〈0.05）, BCMVA（60 cm） was 0.339±0.097 and 0.367±0.101 （P〉0.05） respectively in the two groups at 3 months after the operation. The pseudo accommodation were 1.323±1.033 and 1.301±1.127 in the two groups at 3 months after the operation （P〉0.05）. There are two peak focus in the two groups at -0.25D, -0.25D and -2.75D, -2.25D respectively in the defocus testing. Con- clusion Patients with Tecnis ZM A00 and ReSTOR ＋3.0D have better BCDVA, BCNVA and BCMVA （60cm） under light circumstance. Tecnis ZM A00 could provide better BCNVA and BCMVA （60 cm） under shade circumstance.